VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1041559
Sex: F
Age: 37
State: MA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: no known allergies

Symptoms: The patient received their first dose of COVID vaccine on 12/31 at Facility as a healthcare worker. Her employment terminated and she obtained employment at Hospital. She scheduled for her second dose of the series through the Hospital vaccination clinic. She contacted employee health in advance of scheduling her appointment that she should receive her second dose of Moderna. At the time of scheduling, as well as at the time of appointment check-in, she stated that it was her first dose. Through a breakdown in communication, she received Pfizer as her second dose instead of Moderna in error.

Other Meds: unknown

Current Illness: unknown

ID: 1041560
Sex: F
Age: 79
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Novacaine, milk

Symptoms: Rapid heart rate , hot, stinging, flushed facial skin Unsteadiness, lightheadedness

Other Meds:

Current Illness: None

ID: 1041561
Sex: F
Age: 71
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 102 temp for a full day then I was fine.

Other Meds:

Current Illness:

ID: 1041562
Sex: F
Age: 46
State:

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 02/19/2021
Hospital:

Lab Data: 2/11/21 Anti-Sm/RNP 5.9 AI 2/11/21 Anti-SSB 3.1 AI

Allergies: Sulfa

Symptoms: My first Moderna vaccination was on 12/23/20 and 8 days later, on 12/31/20 I suddenly developed significant Raynaud's phenomenon (up to 10 episodes a day) followed by severe persistent finger pain. Subsequently had positive anti-Sm/RNP at high titer as well as positive anti-SSB antibodies and have been diagnosed with Undifferentiated Connective Tissue Disorder. Prior to 12/31/20, I had never had an episode of Raynaud's or any autoimmune disease.

Other Meds: Multivitamin

Current Illness: None

ID: 1041563
Sex: F
Age: 85
State: ID

Vax Date: 01/23/2021
Onset Date: 02/03/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data: Multiple lab results, see above.

Allergies: Penicillin.

Symptoms: She had her vaccine, and 11 days later noticed her stool was very black like tar, and on the side had bright red blood. She went to the ER and she was admitted. They did an endoscopic exam but did not find anything. She then was discharged after a couple of days. She had an APT with her PCP on 2/9/21 and she had ordered blood work, and nothing changed. She ordered a repeat blood work on 2/13/21 and said that her count was 6.9, and was told to come in for some blood, and admitted again for a couple of more days. She had one unit of blood. She was discharged on 2/15/21. She saw a gastroenterology NP and she drew blood and her count was 8.4, and advised to start taking some iron. She does not show any further signs of bleeding, but does feel very weak, feels cold and the usual signs of anemia. She did have light headedness throughout this entire time as well.

Other Meds: Amlodipine, Pantoprazole, Levothyroxine, Pravastatin, Advair inhaler, calcium, zinc, Fibercon, oxygen 24/7, multivitamin, Benadryl daily.

Current Illness: None.

ID: 1041564
Sex: F
Age: 59
State: TX

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: N/A

Allergies: Fluconazole, environmental allergies

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Approximately 30 minutes after shot, got a very bad taste in the mouth, then throat became numb and I could not swallow unless I really forced it. I had to drink to be able to swallow. Again had to really try before I could. Then roof of mouth, back of throat and back of tongue felt number as if I had novocaine. The lack of swallow lasted about 10 minutes of forced swallowing. The numbness continued for about 2 hours but I was able to do everything. The numbness was more of an annoyance.

Other Meds: Trulicity, Levemir, Humalog, Invokamet, Vascepa, Atorvastatin, Losaratin, Multi Vitamin, Magnesseum, Super B Complex, Zinc, Vitamin D3 (ivermectin 2 weeks before for COVID 19).

Current Illness: Covid 19

ID: 1041565
Sex: F
Age: 69
State: NY

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Extreme dizzyness, nauseous, vomiting, diarhea. Went to Hospital to get medication and performed tests

Other Meds:

Current Illness:

ID: 1041566
Sex: M
Age: 95
State: OK

Vax Date: 01/04/2021
Onset Date: 01/25/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Rash, physician recommended to use benadryl

Other Meds: metorprolol eye drops

Current Illness: none

ID: 1041567
Sex: F
Age: 72
State: MD

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None known

Symptoms: About an hour after I got the injection, I started sneezing, about 10 times in a row. I had two more such sneezing episodes that day and one again the next morning. There was no other reason that I could think of -- no odors in my house, nothing food-related, etc. -- that could account for that. I thought that maybe I was getting a cold, but that is not the case, and the sneezing fits have stopped.

Other Meds: Losartan, diclofenac, amlodipine, calucim, vitamin D, Centrum

Current Illness: None

ID: 1041568
Sex: F
Age: 67
State:

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: A few days after shot felt slightly nauseous, slight tingling and swelling of lips and Irritable Bowel Syndrome was triggered with diarrhea.

Other Meds: None

Current Illness: None

ID: 1041569
Sex: F
Age: 28
State: WA

Vax Date: 12/28/2020
Onset Date: 01/07/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: On 01/07/2021 in the morning I got a rash on my face. My face felt itchy I had bumps on my face & it was very red. It went also to my neck. I had to take Benadryl & it resolved the same day.

Other Meds: Vitamin D Amitriptyline

Current Illness: No

ID: 1041570
Sex: M
Age: 53
State: CT

Vax Date: 01/11/2021
Onset Date:
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Bump under right armpit felt/noticed on 01/16/2021. It has almost disappeared. My psoriasis on arms/legs apparently temporarily cleared up. It apparently may unfortunately be returning. My white blood cell count had apparently gotten back to normal levels after the 1st vaccine injection on 01/16/2021.

Other Meds: N/A

Current Illness: N/A

ID: 1041571
Sex: F
Age: 73
State: IL

Vax Date: 02/05/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Penicillin, Sulfa, Codeine, Minocycline, some antibiotic ointments, bug bites (epi-pen)

Symptoms: 2/14 large, red, hot blotch - 10 days after receiving vaccine 2/15 treated at convenient care for cellulitis, prescribed Doxycyline 2/19 primary care physician said no cellulitis, just a vaccination reaction/rash rash is fading

Other Meds: Alprazolam, Ergocalciferol, Fluoxetine, Levothyroxine, Losartan, Miralax, Simvastatin, Tums, Viactiv, Prolia

Current Illness: None

ID: 1041572
Sex: F
Age: 57
State: CA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Chills, nausea, body pain whole body,, joint sensitivity, loss of appetite, headache.

Other Meds: B12, Zinc, D3, C

Current Illness: None

ID: 1041573
Sex: M
Age: 88
State: AL

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: no

Allergies: Penicillin

Symptoms: feels like there is a lump in his throat, and feels like it is swelling

Other Meds: Lopressor, lipitor, methatrexate

Current Illness: no

ID: 1041574
Sex: F
Age: 50
State:

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt reported severe fatigue and off and on nausea. Fatigue continues. Also reported numbness of left pinky and part of palm two weeks following vaccine. Visit with provider, determines that numbness is not related to vaccine. Pt received second dose of Moderna vaccine 2/16/21. Lot # 006M20A. exp 7/12/21. at 9:00 am. Left deltoid IM, fatigue continues

Other Meds:

Current Illness:

ID: 1041575
Sex: F
Age: 77
State: OR

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: codeine ciprofloxacin nitrofurantoin sulfa MSG walnuts dairy grass pollen

Symptoms: Starting about 2 days after the vaccine I have had painful muscle and joint pain. It is painful whether I am stationary or moving...it doesn't seem to make a difference. I take aleve to help with the pain. I am questioning whether to go for the second dose in under3 weeks since the pain does not seem to be lessening after ten days.

Other Meds: albuterol 90mcg allegra allergy fish oil joint health caps levothyroxine 75 mcg magnesium 300mg multivitamin potassium turmeric cur cumin vitamin c vitamin d zinc

Current Illness: none

ID: 1041576
Sex: F
Age: 16
State: CO

Vax Date: 01/09/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Not on file

Symptoms: COVID Moderna vaccine given to unapproved FDA age group. This is a vaccination error. A COVID19 Moderna vaccine was given to a 16 y/o. Patient was not on the schedule. It was at the end of the shift and extra dose was left due to no show. Vaccine coordinator contacted the patient from the waitlist. Patient received a total of 2 doses. The patient received the first dose of Moderna on 1/19/21, and second dose on 2/6/21. No adverse reaction was reported. 1st Dose lot #: 029L20A given on LD 2nd Dose lot #: 011J20A given on LD

Other Meds:

Current Illness:

ID: 1041577
Sex: F
Age: 45
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: I met with the physician and she recommended to inform you of this unusual side effect.

Allergies: None

Symptoms: I have developed all the indicated possible adverse reactions (e.g. fever, chills, body aches, exhaustion, headache, nausea) but also a DRY COUGH that continues for several days.

Other Meds: None

Current Illness: None

ID: 1041578
Sex: M
Age: 31
State: AZ

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: Ibuprofen, Demerol, Crab

Symptoms: Achiness all over, headache, fatigue, nausea

Other Meds: Flonase nasal spray, Vitamin C powder, Multivitamin, Vitamin D supplement

Current Illness: none

ID: 1041579
Sex: F
Age: 74
State: PA

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site rash began on day 9. No pain, just redness surrounding injection site.

Other Meds:

Current Illness:

ID: 1041580
Sex: F
Age: 34
State: OH

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: Continued low grade fevers, chills, myalgia and headache 14 days following vaccination

Other Meds: Augmentin, Asmanex HFA

Current Illness: Sinusitis

ID: 1041581
Sex: F
Age: 81
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Pt will return to clinic on 3/1/21 to have lab work completed.

Allergies: NKA

Symptoms: Pt possibly received normal saline diluent instead of the Pfizer vaccine. There was an error in preparation. Pt was contacted on 2/16/21. No adverse reaction reported.

Other Meds: amlodipine 10 mg oral tablet take 1 tablet (10 mg) by oral route once daily

Current Illness: UNKNOWN

ID: 1041582
Sex: F
Age: 42
State: AR

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: About 3 hours after the afternoon shot, I noticed I began to feel bad. Not in any specific way, just bad. That evening, I noticed chills, pressure at the top of my head, sensitivity to sounds, and aching body. That night, I had trouble sleeping due to all of this. The next day, an additional thing I noticed was how much my lymph nodes hurt, especially in the throat and armpits. The left armpit in particular was more swollen and painful than at any other time in my life. I could not put my arm down without pain. The day after that, the feelings subsided. This 3rd day after the shot, my left armpit lymph node is a little sore, but I am able to do my daily activities. I took children's chewable aspirin tablets the first evening, day and 2nd evening.

Other Meds: 1) Buproprion HCl tablet 150 mg XL: Take 1 tablet by mouth daily. 2) Citalopram tablet 40 mg: Take 1 tablet by mouth daily. 3) Tramadol HCl 50 mg tablet: Take 2 tablets by mouth every 6 hours. (I end up taking 0-4 tablets per month.) 4) Pr

Current Illness: endometriosis flare up starting in the morning of 2/13/21 and ending on 2/15/21.

ID: 1041583
Sex: F
Age: 71
State: IL

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: NA

Allergies: penecillan

Symptoms: 12 hours after injection total body aching and feeling cold started. Got up in middle of the night for bathroom . made it to bathroom before I couldn't hold urine. Remember thinking "O my gosh" Disorientated trying to get back to bed. Kept running in to walls. 75 hours after injection still not fully recovered but feeling much more normal.

Other Meds: carvedilol 25mg orphenadrin er 100mg losartan 100mg amitriptyline 75mg simvastatin 10mg raloxifine 60mg B-12 1000mcg/day Calcifood by Standard Process nutra-support Bone (calcium, Magnesium, D3) Carlson labs cod liver Oil Cardio-plus by St

Current Illness: NA

ID: 1041584
Sex: F
Age: 58
State: FL

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: The first night (Tuesday 2/9), I was tired. The next morning (Wednesday 2/10), I started with a migraine and was nauseous all day. About 4:30 pm (26 hours later), I started with a fever that ran until Friday morning(2/12). I also had an intense itchy area on the back of my neck/left side and stomach(Wednesday2/10-Thursday2/11). On Thursday, I began having an intense pain in my left breast which I still have today 2/19). I saw my physician on Wednesday, 2/17.

Other Meds: Airborne, Colace

Current Illness: None

ID: 1041585
Sex: F
Age: 56
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: PCN SULFA CLINDOMYOCIN

Symptoms: CONGESTION POST NASAL DRIP SEVERE ACHES CHILLS FEVER HIGH AS 103.7 BODY ACHES

Other Meds: Tamoxafin 20 mg lexapro 10mg

Current Illness: BREAST CANCER, RIGHT POST TWO YEARS BILATERAL MASECTOMY JANUARY 2019

ID: 1041586
Sex: F
Age: 55
State: KY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: xray

Allergies: doxycycline

Symptoms: limited use in left arm. patient states event started approximately 2 hours after 2nd moderna vaccine. Injury mechanism: started after covid vaccine. The pain is present in the upper left arm. The quality of the pain is described as aching. The pain does not radiate. The pain is at a severity of 6/10. The pain is moderate. The pain has been constant since the incident. Pertinent negatives include no chest pain, muscle weakness, numbness or tingling. She has tried acetaminophen and rest for the symptoms. The treatment provided mild relief.

Other Meds: lisinopril, metoprolol, vitamin d, lasix (prn), wellbutrin

Current Illness: hypertension, hypercholesterolemia

ID: 1041587
Sex: M
Age: 64
State: MA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: lamotrigine (rash), asa (seizure)

Symptoms: altered mental status, pt was observed x 15 min, was released, reports taking train and making bus transfer and not remembering how he got home

Other Meds: atorvastatin, amlodipine, hctz, lisinoprkl, carbamazepine, gabapentin, thiamine, amitriptyline

Current Illness: none

ID: 1041589
Sex: F
Age: 28
State: WA

Vax Date: 01/21/2021
Onset Date: 01/26/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: On 01/26/2021 in the morning I got a rash on my face. My face felt itchy I had bumps on my face & it was very red. I had to take Benadryl & it resolved the same day.

Other Meds: Vitamin D Amitriptyline

Current Illness: No

ID: 1041590
Sex: F
Age: 82
State: ND

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Blood work and urinalysis 2/17/2021 follow up UA 2/19/2021

Allergies: None

Symptoms: The vaccine was given on Friday and on the next Tuesday evening she experienced excruciating pain in her joints, knees, arms and elbows. She developed difficulty walking without pain or holding on to something. She also experienced dizziness and headache with balance issues.

Other Meds: losartan 25 mg 1 tab daily vitamin D3 5000 units, 2 capsules once per week allopurinol 100 mg 1 tab daily triphrocaps once daily levothyroxine 100 mg 1 tab daily

Current Illness: None

ID: 1041591
Sex: F
Age: 34
State: TX

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 02/19/2021
Hospital:

Lab Data: NA

Allergies: Unknown

Symptoms: Chills Fever Joint and Muscle Pain Fatigue Injection Site redness and swelling.

Other Meds: Unknown

Current Illness: Unknown

ID: 1041592
Sex: F
Age: 48
State: MA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None yet

Allergies: Penicillin, Bactrim/biactin (only one of those)

Symptoms: Feeling out of my head (6 days so far) dizzy(6 days so far), extreme fatigue (6 days so far) headache (intermittent) chills (intermittent), nausea, weakness (6 days), body and head feel like lead (6 days), chest pains (one day), abdominal pains (1 day), diarreah (1 day), blurred or double vision (two occasions), eyes burning (one occasion)

Other Meds: Multivitamin, Omega 3, Calcium Magnesium, Pottasium, Levoxyl

Current Illness: None

ID: 1041593
Sex: F
Age: 68
State: LA

Vax Date: 02/11/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Sulpha Drugs

Symptoms: Swollen and itchy, burning rash at injection site

Other Meds:

Current Illness:

ID: 1041594
Sex: M
Age: 74
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: NSAIDs

Symptoms: Two 3/4-inch oval white raised patches on left side of tongue.

Other Meds: Famotidine, sumatriptan

Current Illness: None

ID: 1041595
Sex: M
Age: 76
State: IL

Vax Date: 01/26/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Received 2nd dose of Moderna on 1/26/21 and was admitted to the hospital (IVCH) for septic right knee on 2/17/2021

Other Meds:

Current Illness:

ID: 1041596
Sex: F
Age: 61
State: GA

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Aspirin - upset stomach

Symptoms: All of a sudden the flutters would come and I would have headaches when I first got up in the morning. I had body aches, would last all day and I already had pain in the knees but seem more than usual. The pain in the knees come and go.

Other Meds: Eliquis Amlodipine Tyrosine Colcrys Metoprolol lovastatin atorvastatin Albuterol inhaler Tylenol Arthritis

Current Illness:

ID: 1041597
Sex: M
Age: 61
State: OH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Muscle weakness, chills; started 16hrs after dose and lasted another 12 hrs

Other Meds: Juice Plus, Verapamil, Hydrochlorothiazide, rosuvastatin, Colase

Current Illness: none

ID: 1041598
Sex: F
Age: 70
State: NY

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: tuna fish, all fish, penicillin

Symptoms: pt felt cold and headache

Other Meds: metformin, dexilant, atorvastain, antivert (as needed), diazepam

Current Illness: dm, cholesterol, meniers, arachnoid cyst, indigestion

ID: 1041599
Sex: F
Age: 75
State: LA

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Aspirin

Symptoms: Patient woke up 8 days after second dose and started experiencing itching under arms, breast, back, and in groin area. A red color rash developed in all these areas. Patient went to ER and was giving a steroid, pain, and allergy medication but patient not sure names. Patient states rash is still present on back and left arm and is still taking prescribed medication from ER.

Other Meds: Metoprolol XL 50mg, Doxazosin 4mg, Maxzide 25mg

Current Illness: No

ID: 1041600
Sex: M
Age: 68
State: SC

Vax Date: 02/16/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Chills, vomiting, bloated feeling, diarrhea

Other Meds: Nexus 40 MG Valsartan/Hctz 160/25 Livalo 2 MG Magnesium 500 MG CoQ10 400mg

Current Illness: None

ID: 1041601
Sex: F
Age: 43
State: GA

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: My throat became swollen, developed an ulcer-type rash that extended down the backside of both my arms to my elbows, left hand and on my right knee. I was given an EPI shot in the right leg and a shot of Benadryl.

Other Meds: NONE

Current Illness: NONE

ID: 1041602
Sex: F
Age: 71
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None Reported

Allergies: PCN

Symptoms: Headache Fever Burning Eyes

Other Meds: Losartan Amlodipine Folic Acid Methotrexate

Current Illness: None Reported

ID: 1041603
Sex: F
Age: 48
State: IL

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Red, itchy rash at injection site one week after vaccination.

Other Meds:

Current Illness:

ID: 1041604
Sex: F
Age: 81
State: FL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Penicillin, sulfa

Symptoms: Left upper arm soreness began 02/12/2021 with and rash developing approx. 2-3 inches at injection site. Rash with soreness as of 02/19/2021.

Other Meds: Pantoprozole 40 mg, Metroprol 50 mg, Triamterine hctz 37.5, simvastatin 20 mg, aspirin 81mg, Allegra, Potassium 595, Magnesium 250, Multivitamin, Fish oil 2000, I-Caps, Vit. C, B-12,

Current Illness: None

ID: 1041605
Sex: M
Age: 39
State: TX

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: NA

Allergies: Unknown

Symptoms: Chills/Fever Headache Joint and muscle pain

Other Meds: Unknown

Current Illness: Unknown

ID: 1041606
Sex: M
Age: 77
State: IA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Morphine

Symptoms: Patient received 1st dose of COVID vaccination on 2/17/2021 (lot: 031M20A exp 3/11/2021). Wife called today (2/19/2021) to report patient has been experiencing adverse drug reactions: tired, lack of appetite, temperature of 102.9 (eve of 2/18/2021) and 102.4 (am of 2/19/2021), vomiting (phlegm). Patient said he was feeling better this morning and is managing the temperature with acetaminophen. Of historical note, patient did test positive for COVID virus a few months ago. I instructed wife to continue monitoring side effects and encouraged use of acetaminophen to help with fever. I educated that the side effects are "expected" with the exception of vomiting. I also informed her that I would be filing a report with VAERS to report the adverse reaction. At this time, I do not believe these side effects exclude him from receiving the second dose, and I encourage him to still receive the 2nd dose when due (3/17/2021).

Other Meds: Warfarin 7.5 mg daily once weekly, 10 mg daily all other days Torsemide 40 mg daily Benazepril 20 mg daily Atorvastatin 40 mg daily Metoprolol tartrate 25mg twice daily

Current Illness: none

ID: 1041607
Sex: F
Age: 66
State: IL

Vax Date: 02/06/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None so far.

Allergies: none

Symptoms: I an experiencing swelling, redness and itching at the vaccination area..

Other Meds: Metformin, Ozempic, prevastatin.

Current Illness: none

ID: 1041608
Sex: F
Age: 52
State: CO

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: 2/17/21 Glucose 111 Blood urea nitrogen 23 Alkaline phosphate 127 Aspirated aminotransfer 60 My doctor was concerned about my LPT's and glucose and will rerun test in 4 weeks. She asked me to report.

Allergies: Compazine Avocado

Symptoms: On 2/16/21, the morning after the vaccine I had a bad headache and spontaneous nose bleed. That evening I had upset stomach, exhaustion and loose stool. The next day, 2/17/21 I had headache all day and continued exhaustion. In the evening, I took my blood pressure and it was 156/98. An hour later, it was 165/98. By 9:30 p.m it had risen to 172/98 and I was shaking and having difficulty walking/talking. I went to the emergency room. My blood pressure was still 172/98 upon arrival so blood work, EKG, chest X-ray, and CT scan were performed. I was released later that evening when my blood pressure came down to 156/98 . My normal blood pressure is always 120/80 or lower.

Other Meds: N/A

Current Illness: Possible sinus infection

ID: 1041609
Sex: F
Age: 65
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Pt will return to Facility on 3/1/21 to have lab work completed.

Allergies: Lisinopril

Symptoms: Pt possibly received normal saline diluent instead of the Pfizer vaccine. There was an error in preparation. Pt was contacted on 2/16/21. No adverse reaction reported.

Other Meds: Amlodipine 5mg, Carvedilol 3.12mg, HCTZ 25mg, Irbesartan 150mg, Mucinex 600mg

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm